Inqaku
I-methylene blue nemigraine: amabango onyango xa ethelekiswa nentloko ebuhlungu emva kokuyisebenzisa
I-methylene blue ayilonyango oluqinisekisiweyo lwemigraine. Uncwadi lwezonyango olufunyenwe kolu hlolo aluniki ulingo olunolawulo olubonisa ukuba iyaluphelisa uhlaselo lwemigraine, iyaluthintela, okanye inyanga i-aura. Iingxelo zokuthomalala kwentloko ebuhlungu neengxelo zentloko ebuhlungu emva kokuyisebenzisa zinokubakho zombini ngaphandle kokungqina indlela i-methylene blue eyichaphazela ngayo imigraine efunyaniswe ngugqirha.
Esinye isizathu sokubhideka kukuba intloko ebuhlungu inokuthomalala xa kunyangwa unobangela wayo. I-methylene blue isetyenziselwa ukunyanga i-methemoglobinemia efunyenweyo ezibhedlele. Le meko ngokwayo inokubangela intloko ebuhlungu kakhulu efana nemigraine. Unyango oluphumelelayo kuloo meko luphendula umbuzo owahlukileyo kowokuba umntu onemigraine kufuneka asebenzise i-methylene blue na.
Fumana uncedo olungxamisekileyo xa intloko iqala ukuba buhlungu ngesiquphe nangokuqatha kakhulu, xa kuvela ubuthathaka obutsha okanye ubunzima bokuthetha, xa ulahlekelwa zingqondo, okanye xa intloko ebuhlungu ihamba nobunzima bokuphefumla nemilebe eluhlaza okwesibhakabhaka okanye engwevu. Musa ukucinga ukuba ezi mpawu ziyinxalenye elindelekileyo yokuba umzimba uqhelane ne-methylene blue. Isikhokelo se-NHS sentloko ebuhlungu sichaza iintlungu eziqatha eziqala ngesiquphe neempawu zenkqubo yemithambo-luvo njengeempawu zongxamiseko.
Oko kuboniswa ngamabango emigraine ngokwenene
Iingxoxo ezinikiweyo zibonisa amava aphikisanayo: omnye umsonto weforam uxela iintloko ezibuhlungu emva kokusebenzisa i-methylene blue, kanti omnye uqulethe amabango okuthomalala kufutshane nokuqala kohlaselo. Oku ngamava abaliswa ngabafundi, hayi idatha yeklinikhi ebonisa ukusebenza konyango. Ingxoxo yesibini ide ichaze ukungaqiniseki ngamandla esisombululo, nto leyo eyenza kube nzima ukutolika ukuchanabeka.
Uphononongo oluluncedo lonyango beluya kuqinisekisa uxilongo lwemigraine, luchaze ulungiselelo nendlela yokulusebenzisa, luthelekise neqela lolawulo, luze lulinganise isiphumo esinjengokuphela kweentlungu ngexesha elichaziweyo okanye utshintsho kwinani leentsuku zemigraine ngenyanga. Ukuthomalala kwentloko yomntu omnye akunakuthatha indawo yolo thelekiso lungekhoyo. Imigraine iyaguquguquka, abantu badla ngokusebenzisa amanye amayeza, kwaye unyango lunokusetyenziswa xa uhlaselo sele lutshintsha.
Uphando nge-nitric oxide lunika isizathu esisekelwe kwibhayoloji sokuphanda iindlela ezibangela intloko ebuhlungu, kodwa aluqinisekisi ukuba i-methylene blue lunyango. Kuphononongo lwemigraine lukaLassen noogxa bakhe lowe-1998, i-L-NMMA, ethintela i-enzyme i-nitric oxide synthase yaza yanikwa ngomthambo, yathomalalisa intloko ebuhlungu emva kweeyure ezimbini kubathathi-nxaxheba abayi-10 kwabayi-15 abanyangwayo, xa kuthelekiswa nabayi-2 kwabayi-14 kwiqela lolawulo. Noko ke, abathathi-nxaxheba abathathu kuphela abafumana i-placebo babelwe ngokungakhethiyo kolo lingelo; abalishumi elinanye kwiqela lolawulo bavela kwizifundo zangaphambili. Okubaluleke ngakumbi, i-L-NMMA liyeza elahlukileyo. Isiphumo sayo asinakuthathwa njengesesisebenza kwi-methylene blue okanye kwiimveliso ezithengiswayo ezisetyenziswa ngomlomo.
Lo mahluko uyasebenza nakwiphando nge-methylene blue kwezinye iimeko zeentlungu. Inkqubo yonyango lweentlungu ezikwindawo ethile okanye uphononongo lwe-neuropathy aluqinisekisi ukusetyenziswa kwayo kunyango lwemigraine.
Itheyibhile yobungqina: yahlula iimeko zentloko ebuhlungu
| Imeko | Oko ubungqina bubhekisa kuko ngokwenene | Oko bungenakukungqina |
|---|---|---|
| Imigraine efunyaniswe ngugqirha, ene-aura okanye engenayo | Amava akwi-intanethi neengxoxo ngeendlela enokusebenza ngazo; akukho lingo olunolawulo lwe-methylene blue njengonyango lwemigraine olufunyenwe kolu hlolo | Inkqubo yonyango lwemigraine esebenzayo, inzuzo yokuthintela uhlaselo, okanye impembelelo ethembekileyo kwi-aura |
| Uvavanyo lwamayeza kwimigraine | Uphononongo oluncinci lwe-L-NMMA enikwa ngomthambo kwimigraine engena-aura, kunye namaqela ongezelelweyo olawulo afumana i-placebo kwizifundo zangaphambili | Ukusebenza kwe-methylene blue, eyikhompawundi eyahlukileyo |
| Intloko ebuhlungu ebangelwa yi-methemoglobinemia | Uhlolo olupapashiweyo oluquka imeko yentloko ebuhlungu kakhulu, ukujika kolusu lube luhlaza okwesibhakabhaka, nezinye iimpawu ezaphela emva konyango | Inzuzo kwimigraine engabangelwa sesinye isigulo kumntu ongena-methemoglobinemia |
| Intloko ebuhlungu emva kwenaliti ye-methylene blue emiselwe ngugqirha | Intloko ebuhlungu idweliswe phakathi kweziphumo ezingathandekiyo kwileyibhile yenaliti emiselwayo | Ukuxhaphaka kwentloko ebuhlungu ngemveliso esetyenziswa ngomlomo, okanye ukuba yonke intloko ebuhlungu emva kokuchanabeka ibangelwa yidayi |
| Intloko ebuhlungu entsha emva kokuchanabeka ngaphandle kommiselo kagqirha | Imbali yezonyango efuna uvavanyo lwexesha, imveliso, amayeza, neempawu ezihamba nayo | Umlinganiselo we-serotonin, uxilongo olusekelwe kwixesha kuphela, okanye isizathu sokuphinda uchanabeke |
Le theyibhile yahlula amaqela abantu abaphononongiweyo neengxaki zeklinikhi. Ayidwelisi ngokolandelelwano amathuba okuba umntu othile abe nazo.
Kutheni inqaku le-methemoglobinemia lingelolingo lwemigraine
Isalathiso sophando esinikiweyo, Intloko ebuhlungu ne-Methemoglobinemia sikaKhan noogxa bakhe, savela kwi-intanethi ngo-2019 nakushicilelo lwejenali lukaJanuwari 2020. Sihlola intloko ebuhlungu ebangelwa yenye imeko yempilo, kwaye siquka isigulana esineentlungu eziqatha kuyo yonke intloko, ukuntyiloza okujikeleze umlomo, imilebe nezandla eziluhlaza okwesibhakabhaka, isicaphucaphu, nokuphelelwa ngumoya xa sizibhokoxa. Iimpawu zaphela emva konyango lwe-methylene blue.
I-methemoglobinemia itshintsha i-hemoglobin ukuze igazi lingakwazi ukuhambisa ioksijini ngendlela eqhelekileyo. Ukunyanga eso siphazamiso segazi kunokuthomalalisa iimpawu zaso. Ingxelo ilumkisa ukuba iimpawu zaso zinokuphazanyiswa nemigraine ehamba nexhala okanye ukuphefumla ngokukhawuleza nangokugqithisileyo. Ayizange yabele abantu abanemigraine engabangelwa sesinye isigulo ngokungakhethiyo ukuba bafumane i-methylene blue okanye i-placebo, kwaye indlela isigulana esasabela ngayo kunyango ayingqini ukuthintelwa okanye ukuthomalaliswa kohlaselo oluqhelekileyo lwemigraine. Ingcaciso ebanzi yonyango lwe-methemoglobinemia esibhedlele ichaza olo setyenziso.
Kubafundi abakhangela ngokukhethekileyo “i-methylene blue ne-aura yemigraine,” ileta eyapapashwa kamva ichaza i-methemoglobinemia efana nemigraine ene-aura ebonakalayo. Oko kukufana kweempawu xa kuxilongwa, hayi ubungqina bokunyanga i-aura nge-methylene blue. Irekhodi le-PubMed elifumanekayo alinayo isishwankathelo, ngoko iinkcukacha zonyango lweso sigulana azinakucingelwa ngokwesihloko salo.
Intloko ebuhlungu emva kokuchanabeka ayilovavanyo lwe-serotonin
Ulwazi lokumisela i-PROVAYBLUE ludwelisa intloko ebuhlungu phakathi kweziphumo ezingathandekiyo ezixeliweyo. Ezo datha zibhekisa kwimveliso emiselwe ngugqirha nenikwa ngomthambo kwizigulana ezine-methemoglobinemia. Azilinganisi umngcipheko wolungiselelo olusetyenziswa ngomlomo olunezithako nokuchanabeka okwahlukileyo.
Xa kuhlolwa umntu, intloko ebuhlungu entsha inokuba sisiphumo esingathandekiyo, uhlaselo lwemigraine aluqhelileyo, esinye isiphazamiso sentloko ebuhlungu, okanye inxalenye yesinye isigulo. Ixesha libalulekile, kodwa ukuthi “emva koko” akwanelanga ukugqiba ukuba “kungenxa yoko.” Bhala phantsi okwenzekileyo uze ufune ingcebiso ngaphambi kokuphinda usebenzise imveliso engamiselwanga ngugqirha. Musa ukuphinda uchanabeke ukuze uvavanye unxulumano okanye wongeze elinye iyeza ukuze ulwe nesi siphumo.
Inkxalabo ngokusebenzisana kwamayeza iyinyani: uvavanyo ngee-enzyme zabantu ezicociweyo lubonisa ukuba i-methylene blue ithintela i-monoamine oxidase A. Kodwa intloko ebuhlungu ayibonisi umlinganiselo we-serotonin emntwini. Ukuphucuka emva kwenye into okanye ukungabikho kwentloko ebuhlungu akunakuxilonga okanye kukhuphele ngaphandle ityhefu ye-serotonin.
Jonga amagama achanekileyo amayeza emigraine
Unyango lwemigraine lunokuquka amayeza akumaqela aliqela. Ileyibhile ye-sumatriptan ichaza ukuba ayifanele isetyenziswe ngaxeshanye nesithinteli se-MAO-A. Amanye amayeza asetyenziselwa ukuthintela uhlaselo, kuquka amayeza okudakumba, nawo kufuneka aqwalaselwe. Ileyibhile yenaliti ye-methylene blue ilumkisa nge-serotonin syndrome xa isetyenziswa namayeza achaphazela i-serotonin nee-opioid. Usokhemesti ufuna amagama kanye amayeza, hayi nje “iyeza lemigraine.”
Funa unyango olungxamisekileyo emva kokuchanabeka xa ukungazinzi okanye ukudideka kuhamba nomkhuhlane, ukubila kakhulu, ukungcangcazela, ukuqina kwezihlunu, okanye iintshukumo zokuxhuzula. Ezi mpawu zidityanisiweyo zixhalabisa ngakumbi kunentloko ebuhlungu yodwa. Musa ukuyeka iyeza elimiselweyo lokuthintela uhlaselo ukuze usebenzise i-methylene blue, okanye uzenzele ishedyuli yokulinda ukuba iyeza liphume emzimbeni. Isikhokelo sokusebenzisana kwamayeza sichaza amaqela afanelekileyo; ukungabikho kwechiza kuluhlu olufutshane akuthethi ukuba kuvunyelwe ukulisebenzisa.
Bhala phantsi isiganeko ngaphandle kokulibazisa unyango
Khuphela iphepha lokubhala imbali yeempawu ukuze uhambe nalo kwidinga. Libhala isiganeko kunokuba linike uxilongo okanye isindululo sonyango.
Chaza ukuba ezi ntlungu ziyahambelana na nendlela oqhele ukuba buhlungu ngayo, zaqala nini xa kuthelekiswa nokuchanabeka, oko wakusebenzisayo, nezinye iimpawu ezavela. Quka utshintsho kumayeza entloko ebuhlungu owasebenzisa rhoqo nokuba uwasebenzisa kangaphi amayeza okunyanga uhlaselo xa luvela. Ukuwasebenzisa rhoqo kunokwenza kube nzima ukuhlola intloko ebuhlungu.
Isikhokelo se-NICE sokuhlola intloko ebuhlungu sixhasa ukubhalwa kokuba intloko iba buhlungu kangaphi, ihlala ixesha elingakanani, iqatha kangakanani, iimpawu ezihamba nayo, amayeza, nezinto ezinokuyiqalisa. Sikwahlula i-aura eqhelekileyo evela ngokuthe ngcembe ize iphele kwiimpawu ezifuna uvavanyo olongezelelweyo. Isiganeko sokuqala okanye esahluke kakhulu esichaphazela ukubona okanye inkqubo yemithambo-luvo akufanele kuthiwe “yi-aura nje” ngenxa yebali elikwi-intanethi.
Xa intloko ebuhlungu intsha okanye iqhubeka emva kokuchanabeka, yiza nesikhongozeli okanye ifoto ecacileyo yeleyibhile kunye nephepha lokubhala imbali yeempawu kugqirha okanye kusokhemesti. Isikhokelo esibanzi sokhuseleko kunye nemibuzo yengxoxo nengcali yezonyango zinceda ukulungiselela loo ngxoxo ngokwemveliso kanye nokusetyenziswa okucetywayo.